Hurt
by Some Kind of Sin
Summary: Carlisle and Esme are dealt a devastating blow and must find a way to deal with their tragedy. One-shot. AH/AU Rated M for mature themes of grief, loss, self-harm and language.


_**A/N**: I recently experienced a very personal loss. I needed to channel it somehow, but couldn't write about it directly. This is what emerged. _

_**Warning**: This is a dark fic, very different from "Doctor's Orders". Rated M for mature themes of grief, loss, self-harm and some language._

Carlisle x Esme AH/AU

For Sarah

* * *

**Carlisle**

* * *

"Cullen, you're too close to this one. Step back." His hand pulls on my arm, making my blood boil. Does he really think he has the right to touch me?

"Get the fuck off me," I hiss, exploding like an incendiary device and shoving back with all my might. I hear a grunt of surprise as my elbow connects with his diaphragm. I'm vaguely aware of a loud thud and the clang of metal as his body careens into several equipment trays. Snot-nosed punk thinks he's going to pull me out of a trauma? _My trauma_?

A quick glance behind me reveals that someone is helping the cocky young resident up off the floor and righting the instrument trays. He looks both stunned and furious as he brushes debris from his clothes and gets to his feet. I don't have time to care.

"Alice, call OR Eight and let them know we're on our way up. _Now_."

When nothing but silence greets me, I seek her out with steely eyes as my hands continue applying pressure to the arterial spray that's spattered my scrubs in bright crimson. "What? What is it?"

Her dark brown eyes are wide, almost fearful. She has a deer-in-the-headlights look, but maybe that's because she's never seen me lose it. "_What?"_ I snap again impatiently.

"Doctor, your wife is here." Her eyes flit over my shoulder to a crowd of people gathered by the door.

I turn, desperately seeking Esme's lovely face amid a frenetic sea of activity. Our eyes lock briefly, her tortured expression undoubtedly mirroring my own, before I shake my head slightly and look away.

Esme's seen that look before. Her face crumples and she cries out, covering her mouth with her hand. She turns to Jasper, one of our oldest friends, for comfort and buries her head against him. If anyone can help Esme right now, it's Jasper. He has a truly uncanny ability to calm those around him.

"Alice, she shouldn't see this. Can you and Jasper take her to my office and wait for me there?" I manage to get the words out more calmly than I thought humanly possible.

Alice shoots me a concerned look. "What about you? Are you going to be okay?"

I manage to convince her with a firm nod, but we both know it's a lie. I'm grateful that she understands what I need though. She removes her gloves and presses her lips together with a sad expression, like she wants to say something but doesn't know what. She gives me one last sympathetic glance before she quickly glides across the room and whispers quietly to her husband.

Oxygen and various other monitors are beeping—a cacophony of sounds all competing for my attention. Once a confident conductor of this complex symphony, it is quickly becoming my nightmare. Above it all is one very fast arrhythmic beeping, the frantic beating of a heart in trouble.

"Carlisle." A warm hand clasps my shoulder. His voice is calm and measured. I turn to meet the sorrow in the eyes of my mentor and the hospital's chief of staff. "Let us do our jobs," Charlie says with a quiet drawl. "You know you're too close to this."

"I can do this," I argue, shrugging his hand away as I continue to bark out orders for a chest tube tray.

He tries again, this time more firmly with a hand on my upper arm. "Go," he says. "Be with your wife."

Rationally I know he's right, but I'm not in my rational mind and I may never be again.

"Charlie, she's my—" I realize I'm shouting now. I don't recognize the sound of my own voice.

"Which is exactly why you shouldn't be working on her." Charlie interrupts calmly. "Let us help her," he says patiently, carefully removing the instrument from my hand like he's negotiating a hostage release situation. Someone steps in and replaces the pressure that my hand has been maintaining. I stare at his perfectly groomed mustache and warm brown eyes, knowing I'd say the same thing to him if he were in my position.

My rigid body suddenly sags with defeat. "Okay, okay," I say hoarsely, slowly backing away, holding up my gloved and bloodied hands in supplication. "But not him," I snarl. "I don't want him anywhere near her." I grind the words out between clenched teeth as I point a finger across the room toward the surgical resident who's standing near the back with crossed arms and a sullen expression. Arrogant prick. Everyone hates him. He's in medicine for all the wrong reasons—just another scalpel jockey looking for bragging rights.

The resident's eyes dart to my mentor, fully expecting him to disagree with the raging lunatic in front of him, but Charlie simply gestures for him to leave with a nod of his head toward the door. The resident shoots me a withering glance but turns and stalks out of the room.

With a sigh of relief, I sag heavily against the wall. A surge of medical professionals press in toward the young woman on the table, propelling me closer to the door in the process.

"Okay everybody," Charlie says with quiet authority as he takes over. "Tensions are high right now. Many of you know this young woman, but I need you to put aside your personal feelings and treat her like any of our other patients. Let's all take a deep breath and focus so we can do our very best to help her."

I peel my gloves off with a loud snap and throw them angrily on the floor. I'm side-lined while they work to save her life and it's making me feel insanely impotent. Adrenaline is pumping furiously inside my chest. My hands are shaking and my ears are ringing. My vision blurs and my heart is pounding so hard I swear I can see each beat pulsing behind my eyes. I bend over and brace my hands on my thighs to keep from passing out. Is it possible to stroke out while surrounded by a room full of physicians? I suddenly want a cigarette although I've never smoked one.

Charlie is calling out orders in a calm, controlled manner while everyone works together in a carefully choreographed dance.

"Type and cross two units of O-neg."

"Chest tube's in," another voice calls out.

"Two lines, wide open."

"Carmen?" Charlie calls out. "Is OR Eight ready?"

"Yes sir," she confirms. "They're prepped and waiting for us."

"Good." His eyes dart to the EKG lines tracing across the heart monitor one more time. He nods, seeming satisfied. "Let's move while she's still relatively stable." He locks the side rails of the bed into place with a loud metallic _thunk _as a team of nurses and doctors ready her for transport, holding IV bags and pumping oxygen into the young woman with a portable bag.

"Carlisle," he says gently, as he releases the foot brake and begins to roll the bed forward quickly. "We'll do everything we can. You have my word on that." He squeezes my shoulder gently. "Get some air and find your wife. We'll keep you updated."

"Thank you," I manage, swallowing hard and nodding at the chief.

I lean down and squeeze her good hand to let her know I'm there. "You're gonna be okay, baby. I love you," I whisper as they start rolling. Our hands separate as they begin moving forward. I hold onto the rail for as long as I can, jogging alongside her bed as they move faster down the hallway.

"Daddy loves you baby!—" I call out as the elevator doors close with a quiet hush in front of me.

I slam a fist against the metal doors in defeat. "Goddammit!"

I sink to my knees, feeling the cold concrete beneath me. A strangled, choking sound is coming from my throat. The reality of what's just happened begins to set in as I stare down the bright red blood soaking my scrubs.

It is the last time I ever see her alive.

* * *

**Esme**

* * *

_Someone once said that in order to write well, you have to write what you know. _

_I know loss. _

There it sits. My futile attempt to write. Two sentences, naked and abandoned, on the first page of my journal. A line of blue ink skips hard off the page, a testament to my utter frustration and despair. Carlisle encouraged me start writing. I think he's worried that I'll turn into some kind of catatonic vegetable. He says it'll be good for me to get things out.

Truthfully, I don't have the heart or the courage to delve into my feelings. I'm afraid to look at the darkness I'll find there. Besides, it won't bring her back. Nothing will. No matter how hard I cry, or how much I scream, or how much I plead with God, she's still gone.

I'd told her not to come home for Christmas. I-5 out of Seattle had been icy. Why didn't she listen? Why didn't she _ever_ listen? I clutch my hand into a steely fist until my nails dig into my skin. I welcome the pain and press harder, looking for some release to mitigate the painful pressure inside my heart. I rattle the ice in my glass with my other hand, unable to remember when I had polished off the amber liquid inside.

Another day gone. The sun is setting in the west behind the tall fir trees that surround our house. Carlisle will be home soon but I can't summon the energy to change out of my robe, even if it does make him worry less.

A shower and a change of clothes. When had that become too much of an effort?

I'd dragged a chair into her room the day after she died. Three months of watching the seasons change from her window. This was what she had seen every morning when she woke and the last thing she had seen every evening before she slept.

I trace my fingers over the face of the blonde toddler in the photograph clutching her father's hand and grinning up at him with an adoring, toothless smile. Our baby… so much like Carlisle with her father's silky blonde hair and focused determination. She'd even enrolled pre-med for her first semester at school. He'd been _so_ proud. My heart thumps painfully.

I sob in the quiet of her room, grateful for the privacy and beat my fist against the arm of the chair. But not even that gives me relief. I'm numb. Nothing gives me the external physical pain I crave to match the agony that has taken root inside of me.

I reach under our daughter's bed and pull out a box. My fingers brush the row of amber-colored prescription bottles. Carlisle initially had them filled for me, hoping the sleeping pills and anti-depressants would help, but disposed of them when he'd found out about the drinking. I couldn't blame him. I wasn't exactly in my right mind these days.

Unbeknownst to him, I'd had them re-filled at a pharmacy outside of town—in case of emergency, I told myself. He'd never find them here. He hasn't set foot in her room since it happened.

I carry the box with me as I wander down the hallway and into the bedroom I share with Carlisle, making my way to the master bath. I fumble under the sink, finding his medical bag and removing the hard plastic sleeve from a pristine scalpel. I brush my thumb against the razor's edge, welcoming the sting as blood wells to the surface.

I press my hands against the cold marble counter, sobbing at the unfairness of it all—for a promising young life cut short, for all of the things our daughter will never see or do, her college graduation, her wedding, children…our grandchildren. I cry for Carlisle and for me, alone in this empty house that is unbearably quiet.

* * *

**Carlisle**

* * *

My feeling of dread increases as the Mercedes shifts gears and rounds the last corner. Home isn't really home anymore. The sorrow is palpable, permeating every wall and inch of space.

Three months. Three months since the light in our lives was inexplicably extinguished. Three months since Esme has left the house for work or even to see friends. She sits alone in the room that once belonged to our daughter, and rarely leaves.

I've taken her to specialists and various grief counselors and all have agreed that she is clinically depressed, but aside from medications and talk therapy, there is little they can offer except to say, "Give it time."

We rarely speak to each other, much less anything else. Initially, we tried, but if words were painful, touch was excruciating. We've become strangers living under the same roof, scattered to the far corners of a house too large.

I buried myself in work, numbing myself with the adrenaline that comes from a busy ER and the sleep deprivation of too many extra shifts. Esme turned to sleeping pills and alcohol.

I step out of the car feeling a full decade older than I am. I pop the button open on my shirt collar and tug my tie loose as I walk toward the house, wondering what kind of condition my wife will be in.

I drop my jacket and leather bag on the arm of the couch and make my way upstairs with a heavy heart.

Once I reach the landing, I stand in the doorway watching Esme's silhouette in the setting sun. Her feet are tucked casually beneath her in the upholstered wing-back, and for a hopeful moment I think she's all right today until her head slowly bows forward and silent sobs wrack her body.

I move to close the distance between us, my feet moving of their own accord. I want to convince her that I need her as much as she needs me. We can't continue going through this alone.

I drop to my knees in front of her, grasping her hands. "I loved her too," I whisper.

She sobs harder.

I grab a tissue and dab at the tears that are streaming down her flushed cheeks.

"Why her? _Why_?" Esme whimpers, her eyes beseeching mine although she doesn't expect an answer. "It doesn't make any sense. None of it!" She pounds angry fists against my chest, futilely striking at anything within range.

I grab her wrists. "Honey—" I plead.

The words die on my lips as I realize there's blood on my hands.

I scan her hands and arms frantically. "What have you done, Esme?" Cold fear twists a knot in my stomach.

"I needed..." She inhales a shaky breath, unable to meet my gaze. "I needed to see if I could still feel something." She inhales sharply as I turn her arm over, exposing a long and deep wound.

"Jesus!" I cry out, horrified by what she's done. She hisses in pain as I gently probe and inspect the damage. I whip my tie from around my neck and wrap it quickly around her arm.

"I'll need to stitch this," I say, more for my benefit than anything else. I take her other hand and press it firmly against the cut. "Hold this tight," I tell her. "As much pressure as you can. I'll be right back." I scramble to my feet with unsteady legs.

When she doesn't respond, I lean down and lift her chin with my fingers. "Esme, can you do that?" She nods numbly and looks away.

I return minutes later, armed with towels, my medical bag and a suture kit. After securing her arm with a towel, I slide my arms around her and carry her into my office while she holds my supplies.

"It's my fault." Esme swipes at her nose with the back of her other hand as her eyes stare blankly at the trees outside my window. Her words startle me. They are the first words she's spoken since I've begun irrigating the wound and injecting the anesthetic. My eyes flit up to hers and back down to the task at hand. I'm stunned by her declaration, but I wait for her to continue, knowing she needs to get this out.

"I told her not to come until the roads cleared, but she wanted to surprise me for my birthday. _My_ stupid birthday!"

"_Your fault_?" My eyes shoot up to hers, wildly searching her face. "Esme, I couldn't save my own daughter for Christ's sake! What kind of a doctor does that make me? What kind of father am I? I failed her!" I choke back a sob, mid-stitch. The muscles in my jaw ache as I grind my teeth together, attempting to hold back a flood of emotions.

"Carlisle," she whispers, her face softening. "You have to know you did everything you could. No one blames you."

She turns slowly from the window. "No one, honey," she repeats. "Don't you dare think that."

I swallow hard, adding more stitches—six deep and six superficial. Luckily she's missed anything vital. I tie the last suture and wind a bandage around her arm with practiced ease.

I gently kiss the uninjured part of her arm near her wrist. "Please, Esme," I beg. "Don't ever do anything like this—" I choke on my words. "Please," I start again. "Don't leave me. Like this. Ever. We have to get through this—together."

My voice cracks. Hot tears find their release once more. "We'll get help, for both of us."

Esme grabs a fistful of my shirt, burying her head against my chest and weeps with me until we are empty and there are no tears left.

Minutes pass like this in silence before she speaks again.

"I'm so sorry," she says between muffled sobs and gasps for air. "It hurts so much."

She looks up at me as one single tear escapes her bloodshot eyes and trails down her cheek.

"I know, sweetheart." I wipe the tear away with the pad of my thumb. "I know it does."

She eventually disentangles herself and dabs at her red and swollen eyes with a tissue. I barely recognize her. Hell, I barely recognize myself these days. I've become a walking ghost.

"There's no reason for any of this to have happened," I croak. "None of it makes sense. None of it, _goddammit_." I pull her close, closer than we've been in months. "But you still have me," I whisper against her hair. "We're still alive."

I pull her into my arms and rock her gently. "You still have me."

* * *

**As always, Carlisle & Esme love hearing your thoughts...**


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